CHILD HEALTH NURSING. Placement: Third Year. Time: Theory-90 Hrs.

(Class 80 + Lab 10hrs

Practical-270Hrs. + 75 Hrs*

Course Description: This course is designed for developing an understanding of the modern approach to

child-care, identification, prevention and nursing management of common health problems of neonates

and children.

Specific objectives: At the end of the course, the students will be able to:

1. Explain the modern concept of child care and the principles of child health nursing.

2. Describe the normal growth and development of children in various age groups.

3. Explain the physiological response of body to disease conditions in children.

4. Identify the health needs and problems of neonates and children, plan and implement appropriate

nursing interventions.

5. Identify the various preventive, promotive and rehabilitative aspects of child care and apply

them in providing nursing care to children in the hospital and in the community.

Unit LearningObjectives Content Hrs :

allocation.

I *Explain the modern Introduction: Modern concept

of childcare.

Introduction to modern concept of child care &

history, principles & scope of child health

nursing.

Internationally accepted rights of the Child

National policy & legislations in relation to

child health &welfare.

National programmes related to child health &

welfare.

Agencies related to welfare services to the

children.

Changing trends in hospital care, preventive,

promotive & curative aspects of child health.

Child morbidity & mortality rates.

Differences between an adult &child.

Hospital environment for a sick child.

Impact of hospitalization on the child &family.

Grief &bereavement.

The role of a child health nurse in caring for

a hospitalized child.

Principles of pre & post-operative care of infants

& children.

Child health nursing procedures.

T 10 hrs. concept of child P 05 hrs care & principles of 1

child health nursing.

1

*Describe national policy

Progammes & legislations 1 in relation to child health

& welfare. 1

*List major causes of

1

death during infancy,

early & late childhood. 1

*Describe the major

1

functions & role of the paediatric nurse in caring

1

for a hospitalized child. 1

1

*Demonstrate various 5

Paediatric nursing

procedures

Unit Learning Objectives Content Hrs : allocation.

II *Describe the normal The healthy child

Principles of growth &development.

Factors affecting growth &development.

Growth & development from birth to

adolescence

The needs of normal children through

the stages of developmental & parental

guidance

Nutritional needs of children & infants:

Breast feeding, supplementary &artificial

Feeding & weaning.

Baby friendly hospital concept.

Accidents: causes &prevention.

Value of play & selection of play material.

Preventive immunization, immunization

programme & cold chain.

Preventive pediatrics

Care of under five& under five clinics/well

baby clinic.

T 18 hrs. growth &development P 02 hrs of children at different 1 ages 1 6 *Identify the needs of

children at different ages 2 & provide parental

guidance

1 *Identify the nutritional

needs of children at

different ages & ways of 2 meeting the needs. 2 2 *Appreciate the role of

play for normal &sick

children. 1 *Appreciate the preventive 2 measures & strategies for

children.

III *Provide care to normal

&high risk neonates.

*Perform neonatal

resuscitation.

*Recognize &manage

common neonatal

problems.

Nursing care of a neonate. T 12hrs.

P 03hrs.

4

1

4

1

1

1

2

1

Nursing care of a normal newborn /Essential newborn care.

Neonatal resuscitation.

Nursing management of a low birth weight baby &high risk babies.

Kangaroo mother care.

Organization of neonatal unit.

Identification & nursing management of common neonatal problems.

Nursing management of babies with common congenital malformations.

Control & prevention of infection in N.I.C.U.

IV *Explain the concept of

IMNCI & other health

strategies initiated by

National population

policy 2000.

Integrated management of neonatal& 10 hrs.

2

2

1

3

2

childhood illnesses(IMNCI). Health strategies: National population policy-

RCH camps & RCH outreach schemes.

Operationalization of district newborn care, home based neonatal care.

Border district cluster strategy.

Integrated management of infants& children with illnesses like diarrhea, A.R.I., malaria, measles & Malnutrition.

* Nurses’ role: IMNCI.

U nit Learning Objectives Content Hrs : allocation.

V *Provide nursing carein Nursing management in common 20 hrs.

1

2

2

3

2

3

2

1

1

1

1

1

Common childhood Childhood diseases-

diseases. Nutritional deficiency disorders.

*Identify measures to

prevent common

childhood diseases

including immunization.

Respiratory disorders &infections.

Gastro-intestinal infections, infestations,&

congenital disorders.

Cardio-vascular problems: congenital

defects & rheumatic fever, rheumatic heart disease.

Genito-urinary disorders: acute glomerulo nephritis, nephritic syndrome, Wilm’s tumour, infections, calculi, & congenital disorders.

Neurological infections &disorders: convulsions, meningitis, hydrocephalus, head injury.

Hematological disorders : anemias, thalassemia, ITP, leukemia, hemophilia.

Endocrine disorders: juvenile diabetes mellitus& other diseases.

Orthopaedic disorders : club feet, hip dislocation & fracture.

Disorders of skin, eye &ears.

Common communicable diseases in children, their identification, nursing care in hospital& home &prevention.

Child health emergencies :poisoning, haemmorrhage, burns &drowning.

Nursing care of infant and children with HIV/ AIDS

VI *Manage the child with

behavioral & social

problems

Management of behavioural & social 10 hrs.

4

2

2

1

1

Problems in children.

Management of common behavioral disorders.

Management of common psychiatric problems.

Management of challenged children:

Mentally, physically, &socially challenged.

Welfare services for challenged children in India.

Child guidance clinics.

References-

1. GhaiO.p. et al. (2000) Ghai’s Essentials of Paediatrics. 1stedn. Mehta offset works.

NewDelhi.

2. Marlow Dorothy & Redding. (2001) Textbook of Paed. Nsg. 6thedn. Harbarcourt India ltd.

NewDelhi

3. Parthsarathy et al. (2000) IAP Textbook of PaediatricNsg. Jaypee bros., 2 nd ed. NewDelhi.

4. Vishwanathan& Desai. (1999) Achar’s Textbook of Paediatrics 3rded. Orient Longman.

Chennai.

5. Wong Dona et al. Whaley & Wong’s Nursing care of infants & children.6th edn. Mosby co.,

Philadelphia.

6. Dr. C.S. Waghale, Principles and Practice of Clinical Pediatrics, Vora publication1996

PRACTICAL

Time: 270 hrs (9 weeks)

75 Hrs* (2 weeks)

Areas Duration

( in

weeks)

Objectives Skills Assignments Assessment

methods

Pediatric

medicine

ward

3 Provide

nursing

care to

children

with

various

medical

disorders

Counsel

and

educate

parents

Taking pediatric

history

Physical examination

and assessment of

children

Administer of oral,

IM/IV medicine and

fluids.

Calculation fluid

requirements

Prepare different

strengths of IV fluids

Apply restraints

Administer

O2inhalation by

different methods

Give baby bath

Feed children by katori

spoon etc

Collect specimens for

common investigations

Assist with common

diagnostic procedures

Teach mothers/parents

Malnutrition

Oral rehydration

therapy

Feeding and

weaning

Immunization

schedule

Play therapy

Specific disease

conditions

Give care

to three

assigned

pediatric

patients

Nursing

care plan- 1

Case study

/Presentatio

n - 1

Assess clinical

performance with

rating scale.

Assess each skill

with checklist

OSCE/OSPE

Evaluation of case

study /

presentation and

health education

session.

Completion of

activity record

Pediatric

surgery ward

Pediatric

OPD/

Immunization

room

3 Recognize

different

pediatric

conditions/ malformations

Provide pre and

post operative

care to children

with common

pediatric

surgical

conditions/ malformation

Counsel and

educate parents

1 Perform

assessment of

children:

Health,

developmental

and

anthropometric

Perform

immunization

Give health

education/

nutritional

education

Calculate, prepare

and administer IV

fluids Do bowel wash

Care for ostomies:

Colostomy

irrigation

Ureterostomy

Gastrostomy

Enterostomy

Urinary catheterisation

and drainage

Feeding

Nasogastric

Gastrostomy

Jejunostomy

Care of surgical

wounds

Dressing

Suture removal

Assessment of

children

Health assessment Developmental

assessment

Anthropometric

assessment

Immunization

Health / Nutritional

education

Give care to three assigned pediatric surgical

patients

Nursing care plan- 1 Case study /

presentation -

1

Developmental

study -1

Assess

clinical

performance

with rating

scale.

Assess each

skill with

checklist

OSCE/OSPE

Evaluation of

case study /

presentation

and health

education

session.

Completion of

activity record

Assess

clinical

performance

with rating

scale

Completion of

activity

record.

Pediatric medicine and

surgery ICU

1+1

Provide

Nursi

ng

care

to

critic

ally

ill

child

ren

Care of a baby in

incubator /warmer

Care of child on

ventilator.

Endotracheal suction

Chest physiotherapy

Administer fluids

with infusion pump.

Total parenteral

nutrition

Phototherapy

Monitoring of babies

Cardio pulmonary

resuscitation

Nursing care

plan 1

Observation

report 1.

Assess

clinical

performance

with rating

scale

Completion of

activity record

Evaluation of

observation

report.

* 75 Hrs 2 Weeks

Area Duration Objective Skills Assignments Assessment

Pediatric 1 week Provide Integrated Bedside Assess

medicine comprehensive Practice nursing clinical

ward / ICU care to children rounds performance with medical with rating conditions scale

Pediatric 1 week Provide Integrated Bedside Assess

surgery comprehensive Practice nursing clinical

ward / ICU care to children rounds performance with surgical with rating conditions scale

*shifted from Integrated practice

EVALUATION

I. Internal assessment :

Maximum marks 25

Theory: Marks

Midterm 50

Prefinal 75

Total marks 125

Practicum: Maximum marks50

1. Case presentation-

( Paed Medical /Surgical 01) 50

2. Case study - 50

( Paed. medical. / surgical. 01)

3. Nursing careplan03 3 x 25 75

4. Clinical evaluation of comprehensive. 3 X 100 300

( paed. Medical / surgical / P.I.C.U./N.I.C.U.)

5. Health teaching-01 25

6. Assessment of growth & development reports.

(20markseach) 5 X 20 100

(Neonate, infant, toddler, preschooler, & School age)

Observation report of NICU surgery/Medical 1 x 25 25

Practical exam :

1. Midtermexam 50

2. Pretermexam 50

725

II External assessment : University exam:

Theory 75

Practical 50

FORMAT FOR CASE PRESENTATION

Patients Biodata: Name, address, age, sex, religion, occupation of parent, source of health care, date of

admission, provisional diagnosis, date of surgery if any

Presenting complaints: Describe the complaints with which the patient has come to hospital

History of illness

History of present illness – onset, symptoms, duration, precipitating / alleviating factors

History of past illness – illnesses, surgeries, allergies, immunizations, medications

Family history – family tree, history of illness in family members, risk factors, congenital problems,

psychological problems.

Childs personal data

Obstetric history of - prenatal & natal history of mother, growth an development (compare with normal),

immunization status, dietary pattern including weaning, play habits, toilet training, sleep pattern,

schooling.

Economic status of the family: Monthly income & expenditure on health, food and education material

assets (own pacca house car, two wheeler, phone, TV etc…)

Psychological status: ethnic background, (geographical information, cultural information) support

system available.

Physical examination with date and time

Investigations

Date Investigations done Normal value Patient value Inference

Treatment

Sr.

No.

Drug

(Pharmacological name)

Dose

Frequency

/ Time

Action

Side

effects &

drug

interaction

Nursing

responsibi-

-lity

Description of disease

Definition, related anatomy physiology, etiology, risk factors, clinical features, management and nursing

care

Clinical features of the disease condition

Clinical features present in

the book

Description of clinical

features of patient Pathophysiology

Nursing process:

Patients name Date Ward

Date Assessment Nursing

Diagnosis

Objective Plan of care Implementation Rationale Evaluation

Discharge planning:

It should include health education and discharge planning given to patient

Evaluation of care

Overall evaluation, problem faced while providing care prognosis of the patient and conclusion

Evaluation format for case presentation

SN Content Marks

1 Assessment / Introduction 05

2 Knowledge and understanding of disease 10

3 Nursing care plan 15

4 Presentation skill 10

5 A.V. aids 05

6 Overall

Time 01 Summary& conclusion 02 Bibliography 02 Total 50

Format for case study

Format is similar to case presentation but should be in detail

The nursing care given to the patient should be at least for 5 continuous days

Evaluation format for case study

SN Content Marks

1 Assessment / Introduction 05

2 Knowledge and understanding of disease 15

3 Nursing care plan 20

4 Discharge plan 05

5 Summary & evaluation 02

6 Bibliography 03 Total 50

Nursing care plan

1. Patients Biodata: Name, address, age, sex, religion, occupation of parents, source of health care,

date of admission, provisional diagnosis, date of surgery ifany

2. Presenting complaints: Describe the complaints with which the patient has come tohospital 3. History of illness

History of present illness – onset, symptoms, duration, precipitating / alleviating factors

History of past illness – illnesses, surgeries, allergies, immunizations, medications

Family history – family tree, history of illness in family members, risk factors, congenital

problems, psychological problems

4. Childs personal data

Obstetric history of - prenatal & natal history of mother, growth an development ( compare with

normal ),immunization status, dietary pattern including weaning, play habits, toilet training, sleep

pattern, schooling.

5 Economic status: Monthly income & expenditure on health, food and education, material assets

(own pacca house car, two wheeler, phone, TV etc…) 6 Psychological status: ethnic background,( geographical information, cultural information)

support system available. 7 Personal habits: consumption of alcohol, smoking, tobacco chewing, sleep, exercise, work

elimination, nutrition. 8 Physical examination with date andtime

9 Investigations

Date Investigations done Normal value Patient value Inference

10. Treatment

SN Drug

(pharmacological name)

Dose Frequency

/time

Action Side

effects &

drug

interaction

Nursing

responsibility

11. Nursing process:

Patients name Date Ward

Date Assessment Nursing

Diagnosis

Objective Plan of

care

Implementa –tion

Rationale Evaluation

Discharge planning:

It should include health education and discharge planning given to patient

12. Evalaution of care

Overall evaluation, problem faced while providing care prognosis of the patient and conclusion

Care plan evaluation

1. History taking 03

2. Assessment and nursing diagnosis 05

3. Planning of care 05

4. Implementation and evaluation 08

5. Follow up care 02

6. Bibliography 02

25

EVALUATION FORMAT FOR HEALTH TALK

NAME OF THE STUDENT: ----------------------------------------------------------------------------

AREA OFEXPERIENCE:

PERIOD OFEXPERIENCE:

SUPERVISOR:

Total 100 Marks

Scores: 5 = Excellent, 4 = Very good, 3 = Good, 2 = Satisfactory / fair, 1 = Poor

SN Particular 1 2 3 4 5 Score

1 I) Planning and organization

a) Formulation of attainable objectives

b) Adequacy of content

c) Organization of subject matter

d) Current knowledge related to subject Matter

e) Suitable A.V. Aids

II) Presentation:

a) Interesting

b) Clear Audible

c) Adequate explanation

d) Effective use of A.V. Aids e) Group Involvement

f) Time Limit

III) Personal qualities:

a) Self confidence

b) Personal appearance

c) Language d) Mannerism

e) Self awareness of strong & weak points

IV) Feed back:

a) Recapitulation

b) Effectiveness

c) Group response V) Submits assignment on time

* 100 marks will be converted into25

CLINICAL EVALUATION PROFORMA

Name of the student :

Year :

Area of clinical experience: Duration of posting in weeks:

Name of the supervisor

:

Total Marks: - 100

Scores:- 4 = Very good, 3 = Good, 2 = Satisfactory / fair, 1 = Poor

SN EVALUATION CRITERIA Grades

4 3 2 1

1 Personal & Professional behavior

1 Wears clean & neat uniform and well groomed.

2 Arrives and leaves punctually

3 Demonstrates understanding of the need for quietness in speech & manner & protects the patient from undue notice.

4 Is notably poised and effective even in situations of stress

5 Influential & displaced persuasive assertive leadership behaviour

II Attitude to Co-workers and patients

6 Works well as member of nursing team

7 Gives assistance to other in clinical situations

8 Understands the child as an individual

9 Shows skills in gaining the confidence & co- operation of child and relatives, tactful and considerate.

IV Application of knowledge

10 Possess sound knowledge of pediatric conditions.

11 Has sound knowledge of scientific principles

12 Has knowledge of normal growth and development of children

13 Has knowledge of current treatment modalities inclusive of medicine, surgery, pharmacology and dietetics.

14 Takes interest in new learning from current literature & seeks help from resourceful

people.

SR

NO

EVALUATION CRITERIA Grades

4 3 2 1

V Quality of clinical skill 15 Able to elicit health history of child and family accurately.

Skillful in carrying out physical examination, developmental

16 screening and detecting deviations from normal Identifies problems & sets priorities and grasps essentials while performing duties

17 Able to plan and implement care both preoperatively and post operatively.

18 Applies principles in carrying out procedures & carries out duties promptly.

19 Has technical competence in performing nursing procedures. Able to calculate and administer medicines accurately

20 Resourceful and practices economy of time material and energy.

21 Recognizes the role of play in children and facilitates play therapy in hospitalized children

22 Observes carefully, reports & records signs & symptoms & other relevant information

23 Uses opportunities to give health education to patients &

relatives

24

25

TOTAL

Grade

Very good

=

70 % and above Good = 60 – 69 % Satisfactory = 50- 59 % Poor = Below 50 %

Remarks for improvement:

Student’s Remark:

Signature of the student Signature of the teacher

Assessment of growth & development reports

(Neonate, infant, toddler, preschooler, & School age)

PROFORMA FOR ASSESSMENT OF GROWTH & DEVELOPMENT

(Age group: birth to 5 yrs.)

I] Identification Data :

Name of the child :

Age :

Sex :

Date of admission :

Diagnosis :

Type of delivery : Normal/ Instrumental/LSCS

Place of delivery : Hospital/Home

Any problem during birth : Yes/No

If yes, give details :

Order of birth :

II] Growth & development of child & comparison with normal:

Anthropometry In the child Normal

Weight

Height

Chest circumference

Head circumference

Mid arm circumference

Dentition

III] Milestones of development:

Development milestones In Child Comparison with the

normal

1. Responsive smile

2. Responds to Sound

3. Head control

4. Grasps object

5. Rolls over

6. Sits alone

7. Crawls or creeps

8. Thumb-finger

co-ordination

(Prehension)

9. Stands with support

10. Stands alone

11. Walks with support

12. Walks alone

13. Climbs steps 14. Runs

IV] Social, Emotional & Language Development:

Social & emotional development In Child Comparison with the normal

Responds to closeness when held

Smiles in recognition recognized

mother coos and gurgles seated

before a mirror, regards image

Discriminates strangers wants more

than one to play says Mamma, Papa

responds to name, no or give it to

me.

Increasingly demanding offers cheek

to be kissed can speak single word

use pronouns like I, Me, You asks

for food, drinks, toilet, plays with

doll gives full name can help put

thinks away understands differences

between boy & girl washes hands

feeds himself/ herself repeats with

number understands under, behind,

inside, outside Dresses and

undresses

V] Play habits

Child favorite toy and play:

Does he play alone or with other children?

VI] Toilet training

Is the child trained for bowel movement & if yes, at what age:

Has the child attained bladder control & if yes, at what age:

Does the child use the toilet?

VII] Nutrition

Breast feeding (as relevant to age)

Weaning has weaning started for the child: Yes/No If yes, at what age & specify theweaning

diet. Any problems observed during weaning:

Meal pattern at home

Sample of a day’s meal: Daily requirements of chief nutrients:

Breakfast: Lunch: Dinner Snacks:

VIII] Immunization status & schedule of completion of immunization.

IX] Sleep pattern

How many hours does the child sleep during day and night?

Any sleep problems observed & how it is handled:

X] Schooling

Does the child attend school?

If yes, which grade and report of school performance:

XI] Parent child relationship

How much time do the parents spend with the child?

Observation of parent-child interaction

XII] Explain parental reaction to illness and hospitalization

XIII] Child’s reaction to the illness & hospital team

XIV] Identification of needs on priority

XV] Conclusion

XVI] Bibliography

Evaluation Criteria: Assessment of Growth & Development (birthto5year)

(Maximum Marks: 50)

S.N o. Item Marks 1. Adherence to format 02

2. Skill in Physical examination & assessment 10

3. Relevance and accuracy of data recorded 05

4. Interpretation Identification of Needs 05

5. Bibliography 03

----------

Total 25

-----------

Note: - Same format to be used for assessment of infant, Toddler & Preschooler child.

PROFORMA FOR EXAMINATION AND ASSESSMENT OF NEW BORN

I] Bio data of baby and mother :

Name of the baby (if any) : Age

Birth weight : Present weight:

Mother’s name : Period of gestation:

Date of delivery :

Identification band applied

Type of delivery : Normal/ Instruments/Operation

Place of delivery : Hospital/Home

Any problems during birth : Yes/No

If yes explain :

Antenatal history :

Mother’s age : Height: Weight:

Nutritional status of mother :

Socio-economic background :

II] Examination of the baby :

Characteristics In the Baby Comparison with the

normal

1. Weight

2. Length

3. Head circumference

4. Chest circumference

5. Mid-arm circumference

6. Temperature

7. heart rate 8. Respiration

III] General behavior and observations

Color :

Skin/ Lanugo :

Vernixcaseosa :

Jaundice :

Cyanosis :

Rashes :

Mongolian spot :

Birthmarks :

Head :

- Anterior fontanel:

- Posterior fontanel:

- Any cephal hematoma / caput succedaneum

- Forceps marks(if any) :

Face:

Eyes:

Cleft lip / palate

Ear Cartilage :

Trunk:

- Breast nodule

- Umbilical cord

- Hands :

Feet /Sole creases :

Legs

Genitalia :

Muscle tone :

Reflexes :

- Clinging

- Laughing/ sneezing :

- Sucking :

- Rooting :

- Gagging :

- Grasp :

- Moro :

- Tonic neck reflex :

Cry: Good / week

APGAR scoring at birth :

First feed given :

Type of feed given :

Total requirement of fluid &calories

:Amount of feed accepted :

Special observations made during feed:

Care of skin Care of eyes, nose, ear,

mouth:

Care of umbilicus and genitalia :

Meconium passed /not passed : Urine

passed /not passed :

IV] Identification of Health Needs in Baby & Mother.

V] Health education to mother about Breast feeding

Care of skin, eye and umbilicus etc.

V] Bibliography

Evaluation Criteria: Examination & Assessment of Newborn

(Maximum Marks: 50)

S.No. Item Marks

1 Adherence to format 02

2 Skill in Physical examination & assessment 10

3 Relevance and accuracy of data recorded 05

4 Interpretation of Priority Needs Identification of baby

& mother

06

5 Bibliography 02 ---------

Total 25

----------

Maharashtra University of Health Sciences External Practical Evaluation Guidelines

III Basic B.Sc Nursing Subject : Child Health Nursing

50Marks

Internal Examiner 25Marks

Nursing Procedure (15 marks) Planning and Organizing 5marks

Preparation of tray 3

Environment 1

Preparation of patient 1

Execution of Procedure 7marks

Applies scientific principles 3

Proficiency in skill 3

Ensures sequential order 1

Termination of procedure 3marks

Makes patient comfortable 1

Reports& Records 1

After care of articles 1

Viva(10Marks) 10marks

Knowledge about common pediatric medical surgical conditions 3

Preparation of various diagnostic procedures 2

Instruments and articles 2

Growth and Development 3

External Examiner 25Marks

Nursing Process(15Marks) 15marks

Assessment 3

Nursing Diagnosis 2

Goal 1

Outcome criteria 1

Nursing intervention 3

Rationale 2

Evaluation 1

Nurses notes 2

Viva(10Marks) 10marks

National Health Programs for child care including IMNSI 2

Behavioral and social problem in children 3

Drugs 3

Nursing care of neonates 2

CHILD HEALTH NURSING PRACTICAL EXAMINATION PRACTICAL / ORAL MARK LIST

NAME OF THE EXAMINATION: CHILD

HEALTH NURSING PRACTICALS MONTH: YEAR:

THIRD YEAR Basic B. ScNURSING: MARKS :

50 SUBJECT : CHILD HEALTHNURSING

CENTRE :

Roll No

Internal Examiner External Examiner Total Total

Procedure

Viva voce

Nursing process

Viva voce

15 10 15

10 50

25

Signature of the Internal Examiner Signature of the External

Examiner Date: Date: